Friday Night [under the] Lights 2013

Transcription

1 Friday Night [under the] Lights 2013 Happy Friday. I m writing to you tonight as I try and maneuver my way around Cleon & Dion The evil-chill brother storms chasing after travelers in the central and Western US. As I start writing, I m sitting amidst the grumpies in the Charlotte airport who are angrily informing the overwhelmed gate agents that they just don t understand how important it is for them to get to their final destinations and the airline delays are just unacceptable. It s one of those moments in life where you just don t know exactly what to think. I ll take delays any day over being Breaking News on CNN, thankyouverymuch. Mother Nature often likes to remind us that she s still very much in charge. Seems like there are a lot of impatient people in her waiting room tonight I m really glad I know Dwight Williams. I had a lot to be thankful for last week. Including Dwight Williams. I m really glad I know Dwight Williams. Let me tell you why. Dwight is a PC Maintenance Technician and Systems Admin in our IT Department. He offices in Dallas. I met him many months ago when we needed help with a wireless connection to a projector. He came up to the conference room and quickly and efficiently fixed the problem. Smile on his face Off he went. Then I started having PC problems about a week ago. Outlook was malfunctioning, I couldn t embed a video in Powerpoint and my sound died. With my computer diagnostic skill set, Google provided little useful guidance on how to fix my progressively deteriorating machine. I needed someone that knew what they were doing (sound familiar? Ever think our patients try and figure out & fix their problems and finally realize it s time to call in someone that knows what they re doing?). So, I connected with Dwight while he logged into my computer remotely and started working his magic (interesting side note, he informed me the IT and Compliance staff frequently logs into computers while we re working and just monitors in the background They can even remotely activate the camera on your laptop!).

2 (Just kidding about the stealth snooping) So, making a long story short, over the course of literally 4 days, with multiple on line sessions (including almost 3 hours on a weekend prior to a presentation) and an on-site visit, he solved the problem and was able to rescue files and get me back to normal functioning. So?????? Why am I glad I know Dwight? Don t we expect that kind of responsiveness every day? What s so special about that? Shouldn t we do the same for the people we care for? Absolutely. So, there s more to the Dwight Williams story. Dwight did a tremendous job with my computer and obviously solved my problem (after all, that s what he does, right?). But it was the way he did it that made the experience so much different. As human beings, we pay a lot of attention to not only the WHAT of an interaction with someone (in this case the repair of my computer) but our perceptions of the experience are also very much influenced by the HOW. Think about it The HOW in our world is really a bedside manner, isn t it? It s the way interact, it s how we communicate, it s our non-verbal cues all of those things. Dwight reminded me of several things in medicine that are applicable to our interactions with our patients and their families. Here s what he did: Throughout the entire remote on-line diagnostic and repair process, he not only talked me through what he was doing but he taught me about things along the way. Like, where does your pst file live? What s the difference between a.pst and an.ost file? How can you decrease the number of things that have to crank up when you start your computer so it starts faster? What s the difference between Microsoft Office 2010 and 360? I could go on & on but suffice it to say, he taught me a lot about things I would have never learned about while he worked on the problem at hand. He d always reassure me that things would get fixed. I was ready to throw in the towel on many occasions (I have to admit, the thought of instantly losing all those pending s in one fell swoop had some appeal ). He has a way of putting your mind at ease and instilling confidence that the problem will be solved even when it didn t seem that way to me. He was always upbeat, and never frustrated. I am absolutely sure he was ready to throw his cell phone off the building when my caller ID came up. But he never once hinted at frustration or impatience through our long ordeal. He made sure to let me know that he was keeping copies of my last files around for a while Just in case we needed them. While that may seem trivial, for me it was peace of mind that there would still be hope if this adventure didn t work

3 That s the Dwight HOW. I thought about what his professional style meant in a clinical world. It might look something like this: Ms. Johnson, I m taking your blood pressure now. Any time someone has chest pain, it s important for us to measure the amount a force the heart and blood vessels create as you move blood around the body. It helps us assess one of the factors associated with heart disease and stroke. Do you smoke, by the way? Because that can have significant additive effects on high blood pressure and in some people it can actually cause high blood pressure. Ms. Johnson, we re going to make sure you get taken care of. It may take us some time to sort through, but we ll figure things out don t you worry. Ms. Johnson, I m happy to answer all your questions. I know it can be confusing and scary (I saw a patient once that lost ALL of her Outlook files!! - ). I never mind your questions. What s bothering you right now? I have the time. Ms. Johnson, we ll keep copies of your medical records on file and we ll send them to your doctor so he ll know what we did and he won t have to start from scratch. So, thanks to Dwight. I m glad I know you (but next time, PLEASE figure out a way to irreversibly and mysteriously delete all the s ). You re great at what you do and how you do it What above & beyond looks like on Thanksgiving. Thanks to Melissa Wynstock for passing along this great story from Sylvia Gomez (transport coordinator) in LA: On Tuesday November 26 th we had a patient being discharge home. While waiting for the shuttle she mention being very excited to leave the hospital to go to the Jackson Turkey Giveaway, every year they give people a box which includes a Turkey with everything they need to cook the Thanksgiving Dinner. Long story short she wasn t going to make the cut off time to get her box. I called the Jackson giveaway to see if they would be able to hold a box for her unfortunately they didn t have any more left. She started crying and said that s ok maybe next year. She thanked me for trying. I asked her if she had any money to buy a little turkey she said no until next month when her check arrives. I then asked if she cooked for her family or if her neighbors came over? She said no, I just cook for myself. This patient is on a wheel chair and has Lupus and is non-ambulatory. I told her I would see what I can do but I couldn t promise anything - she smiled and said Thank you. I called around different stores and finally got a hit Vons Market agreed to give us a turkey. I walked over to pick it up I told the Supervisor and the assistant manager the patient s story - they gave me a cart and said fill it up with everything you think she might need and we ll take care of you!!! The Supervisor even gave us a fresh baked pie for her. In addition, several AMR Employees donated cash to help out. Sadie Ryatt, Ray Gaitan, Nathan Trujillo, Jeanette Mendoza and myself. Crew 515 (Ashley Curtis and Lupe Guevara) helped out by driving the food with the cash envelope to our patient s house wishing her a Happy Thanksgiving from AMR.

4 Amazing story. Hat s off to everyone that participated in making that woman s Thanksgiving something to remember forever. If I lived in LA, I d be shopping at Vons, btw Medic 6 Priority One Canine Respiratory Cool story out of our Manchester Practice regarding the team s efforts to resuscitate a dog found inside a burning building. Fortunately, we don t often get presented with a request to resuscitate dogs, but it does happen. The most common event is actually this exact scenario. Many years ago one of my firefighter colleagues came running out of a structure file holding something small & tan in his arms (I immediately thought it was a burned, apneic child). When I approached he handed me a small Chihuahua with agonal respirations. I had absolutely no idea what to do but figured I would treat it like a pediatric resuscitation. Long story short, while there are many anatomic equipment challenges (BVM on dog schnout) the principles of resuscitation are very similar to peds. This particular dog did fine, thank goodness. That night, I actually drove up to the emergency vet center and asked the on-duty vet about dog resuscitation. She was very helpful and verified that dogs are essentially similar in physiology to human pediatrics with a few exceptions (anatomy of the upper airway, ability to use Intraperitoneal approaches or clysis for fluids or meds). It was comforting to get an overview of managing dog & cat emergencies from her. I d highly recommend anyone in emergency care learning the basics of common pet emergencies

5 Just in case : CPR in a dog Lay the dog on a flat surface with his/her right side against the surface. (You will need to stand towards the dog s back.) Put one of your palms on the dog s rib cage, near the heart region, and put your other palm on top of it. Without bending both the elbows, press the rib cage in a downward motion. Compress the chest for one-quarter to one-third the width of the chest for a count of one and then let go for a count of one. Carry on at a rate of 80 compressions per minute. Close the muzzle with your hand before beginning artificial respiration. If only one person is available, breathe into the dog s nose once for every five compressions that are done. If two persons are available, give artificial respiration once for every two compressions are done. Continue performing CPR until the dog begins to breathe and has a steady pulse. If the dog does not show any signs of improvement after 10 minutes of CPR, you can stop as it has not proven successful. Kurt Williams receives the 2013 AAA President s Award Our friend and colleague Kurt received the AAA President s Award at the recent Annual Meeting of the American Ambulance Association. He was recognized posthumously for his dedication to the ambulance industry and the AAA. Over the course of his involvement with the AAA, Kurt became known as a leader, mentor, visionary, and beloved friend. Kurt had many leadership roles in the AAA including Co- Chair of Stars of Life with President Johnson, Chair of Bylaws, and Region V Director. In 2006, he won the President s Award for his work on the Governance Committee. After his untimely death this year, the AAA was proud to found a scholarship fund in Mr. Williams name, to honor his life and work. The Kurt Williams scholarship fund will recognize recipients of the Stars of Life award that exemplify his dedication by sponsoring their attendance to the 2014 Annual Convention and continued leadership training. Deb Gault delivered a powerful emotional tribute I wanted to share her memorial with you It s really nice (thanks, Deb): Hi Thank you all so much. I know Kurt would be so proud and humbled by this recognition especially the fact that it s the President s Award at a time when the AAA President Jimmy Johnson was one of Kurt s closest friends and colleagues. I was very touched and honored to be asked to accept this award on Kurt s behalf today. Kurt and I met in 1985 I realize that I m dating myself by telling you that, but it s true. We were chosen as a small team of 20 and 30 year old somethings to respond to an RFP to provide exclusive emergency and non-emergency ambulance services to Fort Worth, Texas.

6 At the time, Kurt worked for Hartson Medical Services out of San Diego and I worked right here in Las Vegas with Bob Forbuss at Mercy Ambulance Services. Hartson was known for its operational strength and Mercy for its A/R capabilities so the 2 companies responded to the RFP together as a joint venture. When we won, 8 of us were told that we would now have to essentially move to Fort Worth on February 1, 1986 and build an ambulance service from the ground up that could be operational on April 1. Eight of us arrived in Fort Worth on February 1 st and found out that they weren t kidding about the from the ground up part of the project. All that was waiting for us was a stripped-bare closed down used car warehouse with no walls or offices, no personnel, no ambulances, no supplies and no computers. Only 8 of us and 60 days. I remember Kurt being the glue that held us all together at that moment. As we all stood there thinking the same thing how in the world were we going to get this all done, he broke the silence by quoting one of the popular Saturday Night Live characters at the time the Church Lady. He looked at us and said, Now isn t that special? We all burst out laughing and from then on, we took on the job before us with a lot of teamwork and laughter we just dug in and got to work. We literally lived together at the Residence Inn in Fort Worth, working 24/7 and shared a small fleet of 3 identical Fort Taurus rental cars-they were even the same color. Kurt tagged them, Darrel and his other brother Darrel. Working initially out of high rise in downtown Fort Worth and trying to locate one of the three identical cars on one of 6 levels of parking was just one of the challenges we all shared. But, somehow, 60 days later, we proudly watched our first ambulance pull out of the garage at 12:01 a.m. on April 1 st loaded with every supply they would need for any type of call and two fully trained Nationally Registered Paramedics ready to go. We could even process the bill the next day. While all of us agreed we would NEVER want to do that again, I think now, we all look back at that time in our careers and laugh at the funny stories that can only happen when you are totally exhausted and most importantly - we all came away from that experience as a family of friends for life. That was the first time I saw Kurt in action and he earned my utmost respect as an EMS colleague and professional and much more so as an extremely close friend. We just clicked. While our career paths took us to different cities for the next decade or so, our friendship continued to grow with each passing year. I was thrust into working on many projects with Kurt and watched him grow into one of the most knowledgeable and experienced EMS managers that I have met to this day.

7 Describing Kurt to you now to ensure that I give him the justice he so earned and deserves from all of us is a huge challenge. He was a true professional believing first and foremost in providing the highest quality care to the patient nothing else mattered as much as that one goal. He was a gadget geek, known to have the latest electronic device before anyone else even knew it existed. I used to stay at his home when I went to work at the San Diego AMR office after I had moved to Wisconsin and every time I did, he had to give me a 30 minute tutorial just to figure out how to turn on his TV there were (at a minimum), 6 remotes at any given time in his entertainment haven. He finally wrote the instructions down on a document called TV for dummies so he wouldn t have to go through everything with me every time I came to stay. He was a comedian and consummate story teller as any of you that ever attended any type of social dinner or event with him already knows. As someone that was ALWAYS around at the wrong time whenever you did something stupid, he had a memory like a steel trap and inevitably at one of the next dinners or cocktail parties, you would find yourself the subject of his latest tale. Because he was a master storyteller, he also had the art of embellishment down to a science. In fact, about a month before he passed away, I was at a group dinner with him in DC laughing hysterically at a story he was telling about a girl that I was thinking was quite a doofus because of the content of the tale. About ¾ of the way through the story, I realized that the doofus was me it took me that long to get there because the story had grown to about 1000 times the size than the real event but, as with any of his stories of our individual blunders - it was told with a lot of love and they were all incredibly entertaining. He had recently found his perfect niche when our company started a new venture called Evolution Health that involved researching and developing a brand new structure where care could be rendered both in a pre and post hospital environment utilizing state of the art technology. He and one of his closest friends and colleagues, Sharon Henry, worked together to start this venture and Kurt got to be the tech guy that went around finding and then demonstrating all the new gadgets he found that could be used to reach their goals. I have never seen him more enthused about a project he truly was in hog heaven. He believed that EMS had just found its tip of the iceberg stuck as we are now in the clinical transportation service and as healthcare reform developed, he was excited to be on the cutting edge of what we could bring to the table. He was more excited than I had seen him in years he was certainly up to the challenge. And there was no better or more knowledgeable guy for the job.

8 To say Kurt left a lasting legacy on our profession over his 35 year career is truly an understatement. He was a true leader wherever he went within his job, in the communities he lived, within the healthcare profession at large, with the AAA and certainly within AMR and Evolution Health. He was a consummate professional honest, loyal and hard-working to the end. As he continued to strive to be the best at everything he tackled, he was his own worst enemy. With so much to do, taking the time to care for his own health and wellbeing was something that he always put last on his list of things to do. As a result, in April of this year, we lost him way before any of us were ready to let him go. Though time has turned many of our tears to laughter as we recount his antics whenever we are together and we remember his legacy, I know I m not alone when I say that I still miss him every minute of every day. That said, his legacy will continue to live on in the medics that he always found the time to thank and chat with whenever he visited any EMS operation just to let them know that they were the really important part of our team and that were the true professionals that did the critical work that the rest of us simply were here to try hard to support. Starting as a paramedic himself, he was a role model and mentor for so many excited young clinicians and never forgot where his roots were. He fostered programs like the Stars of Life and hung out as much as he could with his clinicians - during EMS week, you could see him at the grill cooking up burgers and hot dogs for his team. He served turkey dinner to his folks on Thanksgiving and always made time to talk with any one of his clinicians that came by and wanted to chat with the guy at the top about something that was important to them or an idea that they thought would make things work better or more efficiently. In honor of the massive contributions that Kurt made to EMS and AMR Evolution Health (the venture Kurt was working so hard on for the past two years) has recently opened a brand new communication center in Dallas, TX geared toward triaging incoming calls to ensure that the right care reaches the right patient at the right time throughout their continuum of care. The facility is named, The Kurt Williams Communication Center.

9 I am proud to say that this award which he would have been very proud of, yet humbled by as well, will reside in the memorial showcase that we are putting together so that no one that goes into that facility will ever have to wonder how or why it got its name. We are all determined to ensure that Kurt will be remembered for the enormous contributions and achievements he made within the EMS community during his short but very LARGE life. While we all will miss seeing his big smile and hearing his infectious laugh, he will always be with those of us that were blessed enough to have him in our lives. He was a caring clinician, EMS professional, fair and loyal to his employees and industry colleagues in all the capacities he served both internally at his job and externally within the industry and communities where he lived. Most importantly, his care and loyalty extended to those of us that were blessed to be his friends in ways that only we can now emulate to ensure that his legacy lives on. By this honor you have bestowed on Kurt today, you have provided those of us that loved him and miss him with a sense of pride and thankfulness by proving that his time, efforts and love for EMS were appreciated and recognized by his AAA colleagues and his tireless work to make a difference truly mattered.to all of us. Thank you again for honoring my friend. Deb Gault Epilogue I think it s only fitting to close tonight with one of my favorite Kurt stories ever. It s in the Epilogue, so you know where it s going. It seems to fit my travel day as well He called it his Southwest Airlines Seating Strategy: - Go to the restroom before boarding and get a bunch of folded toilet paper - Board the plane as early as you can and take a middle seat - Take half the folded toilet paper and create 4-5 folded pieces and set them on the seat by the window - Take the remainder of the toilet paper and crumple up 8-10 pieces and set them on the aisle seat - Place one folded segment over your nose & mouth and look up at everyone walking down the aisle - The Kurt Williams Seat Saver Maneuver - Works like a charm

10 That s it from my world. Happy Friday. As always, thanks for what you do and HOW you do it Ed Edward M. Racht, MD Chief Medical Officer AMR / Evolution Health ed.racht@emsc.net